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PubMed2002

Correlates of load carriage and obstacle course performance among women.

To examine correlates of the speed at which female soldiers carrying loads could cover 3.2 km on foot and traverse an obstacle course, 12 volunteers (mean +/- SD: 25.3 +/- 6 years, 166 +/- 7 cm, 61.3 +/- 7 kg) were timed over 3.2 km while carrying loads of 14, 27, and 41 kg, and while traversing an obstacle course with the two lighter loads. Pearson correlations showed that absolute VO_[2 max] and 3.2 km run time without a load were the best predictors of 3.2 km load carriage time for all loads. Also, larger subjects with greater muscle mass were able to carry the heaviest load faster than smaller, less muscular subjects, likely because the 41 kg load represented a smaller percentage of the former's bodyweight. Maximum number of sit-ups and push-ups, composite score of the Army Physical Fitness Test as well as body height were positively correlated with the speed at which some course segments were traversed.

Female↗
PubMed2002

[Frequency of occurrence of traumatic aortic rupture in automobile passengers involved in a frontal crash with a static or dynamic obstacle].

There is a lesion of aortic thoracic complex in car-passengers during the frontal clash to a static or to a dynamic antipodal obstacle is described in this study. It is a retrospective analysis. Facts were noted especially from dissectional documents. All from 298 men died. The main cause of car-passengers death was a weighty traumatic lesion of cardiovascular system in 58.7%. The aortic rupture was noted in 98 (32.9%) people, the death was in 90.8% directly on the road and 9.2% at hospital. From the whole people who were accepted to a hospital were 9 (8.9%) with a traumatic aortic rupture. But nobody of them was transported to a special center and everyone died due to traumatic lesion of cardiovascular system. Statistical significant cofactors of aortic rupture were atherosclerosis of aortic wall and intensity of clash. Therefore we can expect an aortic rupture in every third dead frontal car crash participant on a dynamic or static obstacle. Nearly 10% from men with traumatic aortic rupture were transported to a hospital. No aortic rupture was diagnosed.

Accidents, Traffic↗
PubMedDate not supplied

Women in academic medicine: perceived obstacles to advancement.

To investigate perceived obstacles to the advancement of women in academic medicine, we sent a questionnaire assessing perceptions of the fairness and supportiveness of the academic environment to the 229 female teaching and research faculty of the School of Physicians & Surgeons at Columbia University. The overall response rate was 85%. Forty-six percent believed that they had not had the same professional opportunities as their male colleagues, 52% believed that salaries were not equivalent for men and women in similar positions, and 50% believed that promotions were awarded in a biased manner. Thirty percent reported that sexist behavior was common and that sexual harassment occurred in the workplace. Eighty-one percent experienced conflicts between their professional and personal lives and most believed that the institution failed to adequately address the needs of women with children. This survey indicates that there are significant perceived obstacles to the advancement of women in academic medicine that must be addressed.

Career Mobility↗
PubMedDate not supplied

[Unidirectional block of propagation of a single autowave in a narrow gap and emergence of a two-dimensional reentry depends on geometry of the obstacle and on excitability of the media].

Using mathematical simulation we show that the occurrence of excitation wave circulation (reentry) around an unexcitable obstacle depends on both the geometry of the obstacle and the excitation threshold. The reentry formation is shown to take place in a wide range of model parameters.

Models, Theoretical↗
PubMed2003

[Health promotion benefits and obstacles as perceived by occupational medicine physicians in Poland].

This article presents the views of occupational medicine (OM) physicians concerning the following: (a) whether OM physicians should be involved in workplace health promotion: (b) whether they can benefit (if so in what way) from involvement in this activity; (c) whether they find the existing conditions favorable for launching health promotion projects; (d) what are the major obstacles? This paper is based on a survey carried out in the fall of 2002 in a group of 325 OM specialists who attend large groups of patients. Over 90% of the respondents believe that OM physicians should be involved in health promotion, however, one third of them do not plan any action in this field in the following year. Among the key benefits from health promotion, health gain is indicated by 80% of OM physicians. Only a few respondents perceive their involvement in health promotion as an opportunity to be more competitive in health service market, thereby to increase their income. None of those interviewed thought that involvement in health promotion win them greater respect among peers. Almost 80% of the respondents complained about unfavorable conditions for carrying out workplace health promotion. As the most significant obstacles they reported the lack of interest in health promotion among employers (86% of respondents), unsatisfactory gratification (76%), limited skill to raise funds for health promotion (64%), limited opportunities to advance education in this field (59%), and the lack of interest in health promotion among employees (57%). In general, OM physicians express their willingness to advance their knowledge of health promotion, although 64% of respondents are convinced that they are well trained in this area. According to the respondents, a proper way to promote health is not only to become very active, but to commit employers to assure the development of health promotion at workplace and to allocate more funds for health promotion projects.

Attitude of Health Personnel↗
PubMedDate not supplied

Health promotion and disease prevention by small rural hospitals: reasons, obstacles, and enablers.

Rural health stakeholders expect small rural hospitals to help improve health status in their communities. Those hospitals may try to offer health promotion and disease prevention (HPDP) services, but they confront big obstacles when doing this. Research interviews with chief executive officers (CEOs) at small rural hospitals found that low reimbursement, community attitudes, inpatient priorities, personnel shortages, low educational levels, weak local economies, and large older populations are often barriers to HPDP. Research also found practical methods that enabled CEOs to overcome obstacles and to offer HPDP in their rural communities. Collaboration with many organizations within and beyond their communities is essential to expand and leverage facilities, equipment, legitimacy, funds, interpersonal connections, knowledge, and resources. Philanthropy, grant writers, and grants are important, as is the involvement of employee champions and volunteers. Political advocacy can help. Implementing these enablers requires effective leadership, communication, interpersonal relations, and trust building.

Health Promotion↗
PubMedDate not supplied

[The rotation of autowaves as a result of their penetration through a system of unexcitable obstacles. A mechanism of arrhythmias associated with aging].

The dependence of the frequency of occurrence of excitation vortices rotating around unexcitable obstacles on the size and the number of the obstacles and also on the medium excitation threshold was studied. It was shown that the vortex formation takes place in a wide range of the model parameter values. The assumption was formulated that the mechanism of formation of excitation vortices under study underlies the increase in the heart arrhythmias associated with aging.

Aging↗
PubMed2006

Initiating abortion training in residency programs: issues and obstacles.

OBJECTIVES: Early abortion is a common outpatient procedure, but few family medicine residencies provide abortion training. We wished to assess experiences and obstacles among residency programs that have worked to establish early abortion services. METHODS: From 2001-2004, 14 faculty participated in a collaborative program to initiate abortion training at seven family medicine residencies. Ten focus groups with all trainees were followed by individual semi-structured interviews with a smaller group (n=9) that explored the progress and obstacles they experienced. Individual interviews were recorded and analyzed to identify major themes and sub-themes related to initiating abortion training. RESULTS: Five of seven sites established abortion training. Five major themes were identified: (1) establishing support, (2) administration, (3) finance, (4) legal matters, and (5) security/demonstrators. Faculty from sites where training was ultimately established rated the sub-themes of billing/reimbursement, obtaining staff support, and state/hospital regulations as most difficult. Gaining support from within the department and institution was most difficult for the two sites that could not establish training. None experienced difficulty with security/demonstrators. CONCLUSIONS: Developing the clinical and administrative capacity to provide early abortion services in family medicine residency programs is feasible. Support from leadership within departments and from the wider institution is important for implementation.

Abortion, Legal↗
PubMed2005

Overcoming obstacles to collecting narrative data from eye care professionals at the point-of-care.

Capturing the nuances of clinical observations in an electronic format has been a major challenge in implementing electronic health records. In a formative evaluation study using three different methodologies, we identified that the greatest obstacle to point-of-care data entry for eye care was supporting free text annotation of clinical observations. To overcome this obstacle, we developed an approach that captures an image of a free text entry and associates this image with related data elements in an encounter note. Through simulated patient studies, we observed that this approach successfully supported complex documentation at the point of care by clinicians.

Attitude to Computers↗
PubMed1990

Evaluation of an indoor standardized obstacle course for Canadian infantry personnel.

This study compared performance on an indoor standardized obstacle course (ISOC) to laboratory measures of fitness recognized as important in the performance of infantry tasks. The course involves 19 obstacles consisting of running, crawling, scaling, pulling, lifting, carrying and pushing activities arranged in sequential order. Forty-three healthy males between 21 and 31 years of age participated in the study. Performance scores on the ISOC were found to be significantly (p less than 0.01) and positively correlated to maximal aerobic power (MAP), muscular strength and endurance and anaerobic lactic power, and negatively correlated to indices of body fat. Stepwise multiple regression analysis indicated that 81% of the variance in ISOC performance time was accounted for by MAP, a strength index, anaerobic lactic power and sum of four skinfolds.

Adult↗
PubMed1989

[Study of excitation circulation around an unexcitable myocardial obstacle].

An experimental model of tachy-arrhythmias due to myocardial excitation wave circulation round an unexcitable obstruction was explored. Artificial openings of various sizes and shapes in an isolated rabbit left atrium posed as obstacles. Acetylcholine, having a potent effect on the refractory period of atrial cells, was used to alter refractory characteristics. It has been demonstrated that differences in the sensitivity to the action of pharmacologic agents on both re-entry types can actually be absent. Acetylcholine is shown to shorten the period of circulation round the hole, i.e. act on such circulation in the same fashion as it does on the leading cycle, in a wide range of hole diameters, approaching the ones comparable with the size of the atrium. Sensitivity to acetylcholine only disappears when a labyrinth is set up with artificially prolonged circulation pathway. The action of acetylcholine can be attributed to the absence of tissue with fully recovered excitability between the anterior and posterior fronts of the wave circulating round the obstacle.

Acetylcholine↗
PubMed1985

Obstacles in the prevention of psychological sequelae in survivors of childhood cancer.

This article reviews some of the elements of surviving childhood cancer. It is evident that there are psychological, social, and neuropsychological sequelae of surviving cancer; and therefore there is a need for prevention of psychological sequelae in survivors of childhood cancer. This article outlines four obstacles to their prevention--the lack of adequate research, the distribution of resources, professional attitudes, and the "Damocles syndrome" perspective--and suggests some means by which these obstacles may be overcome.

Adaptation, Psychological↗
PubMed1983

Obstacles to continuing education.

An earlier study showed that low attendance at section 63 courses of continuing education was not explained by dissatisfaction with content or methods employed in these programmes. In this enquiry to the same sample of 105 general practitioners, several additional factors were studied related to enjoyment of professional role, practice skills and perceived obstacles to continuing education. Thirty-seven per cent of respondents said that their work was less than fully enjoyable and one in 20 found no enjoyment; similarly, 30 per cent were dissatisfied with their organizational skills but for neither of these factors was there any difference between attenders and non-attenders. Half of the sample found difficulty in keeping up to date, and in this finding the proportion who were attenders was significantly higher than non-attenders. Eighty-two per cent had encountered obstacles to their continuing education, in particular lack of time, practice commitments and the need to preserve family life. Recommendations for an ideal system of continuing education included high acceptance of self-assessment exercises as a means of identifying areas of educational need.

Education, Medical, Continuing↗
PubMed1994

Obstacles and approaches to clinical database research: experience at the University of California, San Francisco.

With increasing availability of clinical data in machine-readable form, and decreasing cost of storing and manipulating that data, retrospective research using clinical databases has become more feasible. Nonetheless, much of the potential for clinical research using these data remains unrealized. Obstacles to clinical database research include difficulty accessing data, difficulty using retrospective data to draw valid inferences about medical tests and treatments, and a shortage of investigators trained and interested in using a clinical database to answer their questions. At the University of California, San Francisco, we have developed a Clinical Database Research Program (CDRP) to try to overcome these obstacles. The CDRP maintains a relational database of patient data obtained from diverse sources and a small staff dedicated to providing such data to researchers. The CDRP staff also provides support for design and analysis of studies using the database--the development of methods for such studies is our primary research interest. Finally, to increase the number of investigators using the database for research, we are integrating training in clinical epidemiology and clinical research methods into residency and fellowship training, and offering an elective in clinical database research for trainees who wish to undertake a specific project.

Databases, Factual↗
PubMedDate not supplied

Obstacles to effective child welfare service with gay and lesbian youths.

Agencies attempting to develop effective child welfare services for gay and lesbian youths must strive for effectiveness within a policy context that is politically polarized and generates more obstacles than directions. This article argues for a reconceptualization of service delivery that begins with a recognition of the unique developmental challenges facing sexual minority youths and proceeds to an examination of the systemic obstacles to providing competent services in their behalf. An ecological perspective informs the connections between developmental considerations, service issues, and human rights questions.

Adolescent↗
PubMed1993

Obstacles in the application of microencapsulation in islet transplantation.

Several factors stand in the way of successful clinical transplantation of alginate-polylysine-alginate microencapsulated pancreatic islets. These obstacles can be classified into three categories. The first regards the technical aspects of the production process. Limiting factors are the insufficient ability to produce small capsules with an adequate production rate, and insufficient insight into the factors determining the optimal chemical and mechanical properties of the capsules. The second category regards the functional aspects of the microencapsulated islets, such as the limitations of the transplantation site and the absence of a physiologic insulin response of the encapsulated islets to elevated blood glucose levels. The third category regards the fact that survival times of encapsulated islet grafts are still limited to several weeks or months, which is mainly explained by a pericapsular fibrotic overgrowth reaction as a consequence of the bioincompatibility of the capsule membrane. This study describes these obstacles, and thereby summarizes the requirements needed for successful clinical application of encapsulated islet transplantation.

Alginates↗
PubMedDate not supplied

[Cane for the blind with a device for detecting and recognizing pedestrian obstacles].

The paper deals with the development of methods and a device for the blind to walk by orientating himself through remotely contacting study of what has happened and is happening on the road. An optoelectron method for detection of vertical obstacles and ground gaps has been proposed. The authors have drawn up the structural and functional diagrams of a device which is combined with a walking-stick and which makes it possible to detect 3 types of pedestrian obstacles with appropriate sound signalling.

Canes↗
PubMedDate not supplied

Obstacles to prenatal care following implementation of a community-based program to reduce financial barriers.

A study of women who gave birth in a rural Oregon county during 1988-1990 found that despite the establishment of a program to provide prenatal care to low-income women who could not afford it, the most common reasons cited for inadequate prenatal care were financial obstacles. All 13 financial, personal and organizational barriers studied were reported more frequently by the 236 women who received inadequate or no care than by the 246 women who received adequate care. Among the reasons most frequently cited by women who received inadequate care were difficulty paying for prenatal care (70%), difficulty with medical insurance (55%), ambivalence or fear about the pregnancy (46%) and transportation problems (42%). In a logistic regression analysis that controlled for social and demographic characteristics, six barriers were significant predictors of inadequate care: The odds of receiving inadequate care were 7.9 among women who had a poor understanding of or attached a low value to prenatal care compared with those who did not cite this barrier, 3.4 among those who cited financial difficulties, 3.4 among those who said they had difficulty scheduling appointments, 3.0 among those who suffered excessive physical or psychological stress, 2.7 among those who said they did not know where to go for prenatal care, and 1.8 among those who felt ambivalence or fear regarding the pregnancy.

Adolescent↗